ABSTRACT
The COVID-19 pandemic is now a global medical and social problem. Little is known about COVID-19 impact on some vulnerable subgroups, such as immunocompromised patients. Therefore, scientists worldwide show interest in studying the impact of SARS-CoV-2 infection on HIV-positive individuals. We report an autopsy clinical case of a deceased 60-year-old HIV-infected patient with lung damage caused by a combination of the SARS-CoV-2 virus, human herpesvirus 6, cytomegalovirus, and pneumocystis with severe fatal respiratory failure. © 2022, MDV Group. All rights reserved.
ABSTRACT
This Atlas is the result of the autopsies performed by the Moscow Pathology Service for the posthumous diagnosis of presentations and complications of COVID-19 in 2000 cases, the largest number of autopsies of COVID-19 cases in the world. This was accomplished because in Moscow an autopsy is performed in 100 % of fatal cases with suspected COVID-19 with a detailed clinical and morphological analysis. The results of the studies formed the basis of a new methodology that expands upon WHO Guidelines for Certification and Classification (Coding) of COVID-19 as Cause of Death. Transferring this methodology into practice allowed not only to improve reporting of COVID-19-related deaths, but also had a significant impact on the management strategies of COVID-19 patients. A contribution to the theory of pathology is the introduction of the concept of clinical and morphological "masks" of COVID-19. Atlas presents a wide range of signs and complications of COVID-19, which outline ways for further study of their pathogenesis and morphogenesis, improvement of diagnostics and treatment of patients, and a detailed classification of the causes of death directly or indirectly associated with COVID-19. Atlas is intended for pathologists, forensic experts, as well as doctors of all clinical specialties and students in medical schools, including those in advanced training programs of continuing medical education.
ABSTRACT
COVID-19 posed a new challenge to the global medical science, and not all traditional approaches used earlier, for example, in the treatment of SARS and other viral infections, were acceptable. On March 20, 2020, the first fatal outcome from a new coro-navirus infection was registered in Moscow. By the time the article was published (6 weeks later) more than 1000 deaths were reg-istered. Taking into account the fact that there is still a growth in the number of patients and, consequently, deaths, the analysis of lethal outcomes of the first (in chronological order of patients) seems to be extremely relevant. As information about a new coro-navirus infection accumulates, our actions and recommendations on its treatment will change. Most drugs to treat the new coro-navirus infection are still under clinical trials. A vaccine has not been developed, and data on the use of plasma, convalescents, hydroxychloroquine and a number of other drugs are insufficient to provide recommendations that meet the principles of evidence-based medicine. We believe that the analysis of the first 157 fatal cases of a new coronavirus infection is only the first step in the for-mation of carefully verified treatment recommendations. © 2020, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
The research aim is to study the morphological features of COVID-19 in the lungs of patients who died in Moscow from March 20 to June 6, 2020. Methods. Autopsy material of the lungs from 123 deceased (54 women, 69 men) with COVID-19 coronavirus infection (confirmed by PCR) was analyzed, the median age was 71 (30 - 94) years, and the duration of the disease was 14 (3 - 65) days. In all cases, the patient's medical records and autopsy reports were analyzed. Macro- and microscopic changes in the lungs were evaluated in all the observations. Results. The pathology of the lungs in COVID-19 corresponds to various phases of diffuse alveolar damage (DAD). The exudative phase of DAD was detected in 54 (43.9%), the proliferative phase - in 21 (14.63%), and their combination - in 51 (41.46%) of the deceased. Histological features of different phases of DAD are described. Conclusion. An analysis of autopsy material revealed a mismatch between the duration of the course of the disease and the phase of diffuse alveolar damage. A significant portion of the dead found a combination of exudative and proliferative phases of the disease. Histological signs that indirectly indicate a violation of the coagulation system during COVID-19 are described. © 2020 Medical Education. All rights reserved.